· Over two thirds of
all people now living with HIV in the world live in Africa south of the Sahara
desert

· Eighty five percent of the
world's aids deaths have been in the Sub-saharan region.

· Right from the start of the
epidemic, HIV has spread mostly through sex between men and women

· An estimated 87% of children
living with HIV in the world are in Africa

· No cure for aids has yet been
found.

The facts listed above immediately justify organising a workshop
for the women co-ordinators of grassroots women's organisations, to share
experiences on how best we can help to stop the spread of the HIV virus. Why
women and not men? Some might ask. As you will see later in the presentation,
women seem to be the more vulnerable group. The objective is to highlight some
of the pertinent issues regarding HIV and women and to induce the reflection on
the problem of HIV/AIDS in much broader terms than before. To help grassroots
women protect themselves against HIV/AIDS and help to prevent its spread, it is
imperative to have up to date information on these issues in order to transmit
efficiently and effectively accurate and culturally appropriate messages to the
target groups. The issues to be covered in this segment include:

· The extent and
epidemiology of HIV infection in Africa

· Factors that make women,
particularly in Africa more vulnerable to HIV virus

· Problems regarding sexuality
between men and women, particularly in Africa

· Cultural and traditional
constraints and practices - the challenge

· Reduction of risk of infection
in women especially in Africa.

To be able to deal with a problem, one should understand not
just the problem but the magnitude of the problem. We will look first at the
problem as it affects us at individual, country, regional and global level. By
analysing the problem this way, we will then know how to attack it and produce
the appropriate tools to use to induce behaviour change.

First of all, we will note that it is not always necessary to
have scientifically drawn statistics to see the magnitude of the problem and how
it is indeed a pandemic. However, formal statistics can help us to appreciate
not only the magnitude of the epidemic but also to begin to think of appropriate
ways and means of fighting the HIV virus.

Globally, the data show that the HIV knows or recognises only
one totem and that is "HUMAN" and that women are not spared at all. By 1994,
women represented 40% of all new AIDS cases and 50% of all new infections were
women aged between 15 and 29 (SAFAIDS & WHO 1995). Sources including UNAIDS
say that by the year 2000 an estimated 14 million women will have been infected
with HIV and about 4 million will have died of AIDS. The question is " why are
women so vulnerable to HIV infection?" The answer may not be so simple. It is
possible to list the various reasons. These include physiological, social and
cultural, economic, sexual, and sheer ignorance.

PHYSIOLOGICAL FACTORS

Knowing one's body can help individuals gain insight into the
risks of contracting the HIV infection.

What is it about the female physiology that facilitates the
transmission of HIV infection in women?

· Larger mucosal
surface area exposed to the virus

· Greater viral load present in
semen compared to vaginal secretions

· Young girls have immature
cervix and relatively low vaginal mucus production - this present less of a
barrier to HIV

· Older women use various herbs
and powders to make if difficult for penetration thus increasing both men's and
women's pleasure from intercourse - this increases friction and the risk of
lacerations is high

· Vaginal wall is not well lined
with protective cells

· The cervix may be easily
eroded

· Potential bleeding through
tearing of the hymen.

Young women and teenagers constitute the group that is at most
risk. Teenagers are a highly sexually active group and the percentage of young
women pregnant or who have had their first child by age 19 is quite high in most
countries. Most of these young women are impregnated by older men who are mostly
promiscuous and infected. The reasons for younger women involvement with older
men brings us to the second category facilitating factors i.e. social and
cultural factors.

SOCIAL AND CULTURAL FACTORS

These range from rape to beliefs about sex and women in general.

· RAPE - this seems to be
increasing at such an alarming rate. In many Sub Saharan countries it seems no
day passes by without a report on rape or child abuse, e.g.

The causes of rape and child abuse are many. In the different
parts of Africa, beliefs, traditions and cultures as well as perceptions
regarding sex are central to societal norms and behaviours.

The following are some of the beliefs and practices that may
result in either rape or child abuse in the Zimbabwean society:

· Traditional
healers' prescription - to rid yourself of the HIV virus, you have to have
intercourse with a girl under 10 years old.

· Man must regularly release
semen to avoid ill health - the release may be effected through forced sex.

· The father of the groom
should be the first one to have intercourse with his daughter in law in order to
ensure that everything is OK before the son takes over.

· A father should have sexual
intercourse with his daughter to appease the spirits.

All of the above are likely to involve coerced sex which
increases the likelihood of micro lesions in the vaginal mucosae thereby
creating entry points for the HIV virus. Other pertinent factors include:

· POLYGAMY- women are perceived as man's property, therefore a man can acquire as
many as he wants or as his purse can afford to purchase.

· BARENHOOD VS
MOTHERHOOD - no marriage is permitted to be childless hence sharing of wife
with a nephew, uncle or brother is perceived as normal.

· INHERITANCE OF WIDOWS -
belief that a woman is not complete without a man, she is only a property of her
husband's family who has to be repossessed by another member of the family.

· PERCEPTION OF MANLINESS AND
WOMANLINESS - the African society condones male sexual freedom while
emphasising female virginity. Even young boys are encouraged to experiment with
sex before marriage- they must be experienced yet girls must be virgins. If this
practice is condoned note the relevance and implications to married women
of the message "stick to one partner".

All these
beliefs and practices put the woman at risk of HIV infection. As if cultural and
social factors are not enough in constraining a woman's ability to protect
herself from HIV infection, economic factors have been found to be even most
potent in the transmission of the HIV virus.

ECONOMIC FACTORS

· ESAP - with the
introduction of structural adjustment programmes in most of our countries, the
poor are getting poorer thus putting many women and children at risk: many kids
on the street risk being raped and sodomised.

· PROSTITUTION - this has
become a means of survival for many women in our countries thereby risking their
lives.

· SUGAR DADDIES - many
young girls are enticed by older men into sexual intercourse in return for
various material goodies.

· SEXUAL FAVOURS - many
women (men too) are trading sex for a job or just job promotion.

· KNOWINGLY INFECTING -
HIV positives are marrying in order to get someone to look after them when they
become sick.

SEXUALITY

Sex talk

The norm is that sex is not something that you talk about, just
get on with it. Women are supposed to be silent partners who have no say in the
marital affairs let alone sex matters. Hence with this state of affairs, a woman
cannot insist on condom use, if she does the result can be "guilty of mistrust
or infidelity".

Multiplicity of partners

This practice is condoned in men and not in women, women
silently accept this practice, challenging it is unwomanly.

Ignorance

Women may not be very knowledgeable about their bodies
particularly the reproductive system, because of this ignorance they might fail
to recognise any symptoms of STDs or be forced into unprotected sex.

SHEER IGNORANCE

Many women may be ignorant or may not very well understand the
basic facts on HIV/AIDS that they unknowingly and unwittingly put themselves at
risk of infection e.g. young girls and women may be talked into accepting sex
without a condom because they are told by the men that if they do it standing
the virus will not affect them, etc. The ignorance might also be linked to their
strong belief in cultural and traditional practices. The portrait of a good
African woman or (womanliness) and a good African man (manliness) according to
Chigwedere, a well known Zimbabwean historian is as outlined below:

PORTRAIT OF A "GOOD WOMAN"

· Patient· Humble· Pretend
not to know· Subservient· Soft spoken· Less
knowledgeable than a man· Receiver and not
giver· Incubator or producer of
children· Man's toy (hence use of herbs and
extending of labia)· Know that man is always
right

"MANLINESS"

· Physical valour· Sexual valour·
Ability to defend himself and his property women and children included· Ones ability to resist domination by any
woman· Gives effective orders to juniors
(women and children)· Responsible for
feeding his family· Never to be treated like
a woman - hence all the fights that erupted and continue to erupt.· Never to admit that his wife is cleverer than him

(source: Chigwedere: The Abandoned Adolescents)

These values were taught and instilled in boys and girls from
as early as six years of age. The question is: do these qualities of a good
woman place a woman at risk of HIV infection or protect her? In what ways do
they protect the woman? In what ways do they put her at risk?

CHALLENGE - Reduction of risk to HIV infection

Factors that put women at risk of infection seem to centre
around the socialisation of woman as depicted in the above portrait. With a
strong belief in these qualities that make a good African woman, and the African
woman thoroughly socialised to accept and act in line with them, how best can we
as people working with grassroots women help to empower them to make a
difference in guarding their health and protecting themselves against HIV
infection. With no cure in sight, what options do we have? These are
questions to ponder seriously if we hope to design messages and tools that can
effectively empower women to choose between sentencing themselves to death or to
life.

It is true that old habits die hard and old patterns take long
to break. It is also very true that nothing will ever change if no steps are
taken to address the problem. Therefore the initial step to bring about change
is awareness of and acceptance of patterns and behaviours that put women at
risk. Therefore as we work through messages and tools of helping grassroots
women to reduce risk of HIV infection, we must bear in mind an inevitable
objective which is to touch a row nerve, "the belief system" in order to bring
about meaningful change and appropriate behaviours.

True we can give many messages about how to avoid infection, but
without the necessary tools to implement these messages, they will be like, if I
may quote the Bible, 'seeds that fell on a rock that dried up and never
generated'. So as we deliberate on messages and tools let us think seriously
about the implications of the message that we give as well as the appropriate
tools to make the seed germinate and bear fruit. One of the famous messages that
has so far been widely used is " NO condom no sex". This is a very powerful
message, but without first equipping women with appropriate skills to say and
act it out, it is just as good as no message at all. The foundation to changing
patterns is threefold, rights, boundaries and assertiveness. These are the
issues that we shall discuss in the next session on messages and appropriate
tools. For now let's start thinking: Realistically, Appropriately, Practically,
Assertively; in short RAPA.

REFERENCES

1. Chigwedere A. S., The abandoned adolescents

2. Goodman M.S. et Fallon B.C., Pattern changing for abused
women

3. SAFAIDS and WHO; Facing the challenge of HIV/AIDS/STDS: a
gender response

4. UNAIDS, Report on the global HIV/AIDS epidemic, June 1998

5. WHO-global Programme on AIDS: report of a meeting 8-10
February 1995